Abstract:
:Patients with infective endocarditis (IE), have high mortality and morbidity, however, its early diagnosis is difficult. Few studies have examined the delayed diagnosis of IE. We aimed to investigate the factors associated with the diagnostic delay of IE.A retrospective cohort study was conducted for consecutive patients diagnosed with IE in an acute care teaching hospital in Japan from April 2006 to March 2018. Time-to-diagnosis was analyzed using a multivariate Cox hazard model for determining factors associated with days required for IE diagnosis. Factors analyzed in the model included age, gender, activities of daily living, Charlson comorbidity index, presence of internal device, chief complaint, inappropriate antibiotics use, shaking chill, fever >38°C, hypoxemia, serum C-reactive protein (CRP) < 10 mg/dL, Staphylococcus aureus as causative pathogen, findings on first echocardiography, resident as a first contact physician, primary care physician as a first contact doctor, and transport measures to the clinic/hospital.There were 145 IE patients with a mean age of 70 years and 90 were male (62.1%). The median time to the diagnosis of definite IE was 13 days and median time to consider the diagnosis of IE from first clinic/hospital visit was 6 days. The time to consider IE diagnosis was significantly delayed in patients who had inappropriate prior antibiotic use (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.01 to 2.57; P = .045), in patients without fever >38°C (HR, 1.80; 95% CI, 1.11 to 2.90; P = .016), in patients with serum CRP level < 10 mg/dL (HR, 1.53; 95% CI, 1.01 to 2.33; P = .046), and in patients who did not use an ambulance for hospital arrival (HR, 3.18; 95% CI, 1.72 to 5.85; P < .001).Delay in considering IE diagnosis is associated with inappropriate prior antibiotics use, absence of high fever, absence of high CRP level, and use of a hospital arrival vehicle other than an ambulance. For earlier IE diagnosis, inappropriate use of antibiotics should be avoided and IE should not be excluded by relatively low level of temperature or serum CRP.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Nishiguchi S,Nishino K,Kitagawa I,Tokuda Ydoi
10.1097/MD.0000000000021418subject
Has Abstractpub_date
2020-07-24 00:00:00pages
e21418issue
30eissn
0025-7974issn
1536-5964pii
00005792-202007240-00106journal_volume
99pub_type
杂志文章相关文献
MEDICINE文献大全abstract::Cancer patients can be well-connected to resources during treatment but become lost to follow-up and subsequently may receive treatment in free clinics for chronic morbidities. Few studies have examined outcomes for uninsured patients with cancer histories in free clinics, but research examining socioeconomic determin...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013121
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:Chronic active Epstein-Barr virus (EBV) infection (CAEBV) is characterized as chronic or recurrent mononucleosis-like symptoms and elevated EBV deoxyribonucleic acid (EBV-DNA) copies. Cardiovascular complications have high morbidity and mortality. The treatment regimen for CAEBV has not been established ye...
journal_title:Medicine
pub_type: 杂志文章,评审
doi:10.1097/MD.0000000000004384
更新日期:2016-08-01 00:00:00
abstract:RATIONALE:Intravesical migrated intrauterine devices (IUDs) have been reported to cause bladder perforation, stone formation, or malignant transition. However, such extensive intravesical benign hyperplasia caused by an extravesical migrated IUD is firstly reported. PATIENT CONCERNS:A 38-year-old woman suffered from r...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000015671
更新日期:2019-05-01 00:00:00
abstract::Idiopathic pulmonary fibrosis (IPF) is a progressive disease with a poor prognosis. A number of studies reported the association between MUC5B promoter polymorphism rs35705950 and IPF, but substantial inconsistent findings were observed and the strength of association remains unclear.The aim of the study was to invest...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000001901
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The value of layer-specific two-dimensional speckle tracking echocardiography (LS2D-STE) for evaluating viable myocardium (VM) in patients with acute myocardial infarction (AMI) was unclear, this study provides new insights into it and to make a comparison with dualisotope simultaneous acquisition single pho...
journal_title:Medicine
pub_type: 临床试验,杂志文章
doi:10.1097/MD.0000000000013959
更新日期:2019-01-01 00:00:00
abstract::Extra-cardiac abdominal complications are common in left-side infective endocarditis (LS-IE). The aim of this work was to study whether patients with LS-IE presenting splenic, renal, or liver (SRL) involvement seen in abdominal computed tomography (CT) had different clinical features, therapeutic plans, and outcome th...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000011952
更新日期:2018-08-01 00:00:00
abstract::Based on the source of the embolus, septic pulmonary embolism (SPE) can be classified as cardiac, peripheral endogenous, or exogenous. Cardiac SPEs are the most common.We conducted a retrospective analysis of 20 patients with cardiac SPE hospitalized between 1991 and 2013 at a Chinese tertiary referral hospital.The st...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000003846
更新日期:2016-06-01 00:00:00
abstract:UNLABELLED:Cisplatin (CDDP) plus radiotherapy (RT) has been used to treat advanced laryngeal squamous cell carcinoma (LSCC) patients. Single nucleotide polymorphisms (SNPs) may be responsible for differences in chemo/radiosensitivity and side effects in those patients. We reported an advanced LSCC patient, who obtained...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000000578
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:In recent years, the incidence of IBS has gradually increased, and it is considered as one of the most common functional gastrointestinal diseases. However, the etiology of IBS is still unclear, and expectations are rising for more targeted treatments. Many clinical trials have explored the link between Heli...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000022975
更新日期:2020-12-11 00:00:00
abstract::Nonspecific ST-segment and T-wave (ST-T) changes represent one of the most prevalent electrocardiographic abnormalities in hypertensive patients. However, a limited number of studies have investigated the association between nonspecific ST-T changes and unsatisfactory blood pressure (BP) control in adults with hyperte...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000006423
更新日期:2017-03-01 00:00:00
abstract:INTRODUCTION:Prognosis of intrahepatic cholangiocarcinoma (ICC) remained poor despite the multitude advancement of medical care. Resection margin status is one of the few modifiable factors that a surgeon could possibly manipulate to alter the disease outcome. However, the significance of margin status and margin width...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000004133
更新日期:2016-07-01 00:00:00
abstract:RATIONALE:Takotsubo syndrome (TTS) most commonly occurs in postmenopausal women who have been exposed to a triggering event such as acute physical or emotional distress. Sepsis-induced TTS in young premenopausal women were rarely reported. In particular, the relationship between sepsis-induced TTS and sepsis-induced ca...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000013718
更新日期:2018-12-01 00:00:00
abstract::Immune cells contribute to determining the prognosis of gastric cancer. However, their exact role is less clear. We determined the prognostic significance of different immune cells in intratumoral tissue (T), stromal tissue (S), and adjacent normal tissue (N) of 166 gastric cancer cases and their interactions, includi...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000001631
更新日期:2015-09-01 00:00:00
abstract::Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease. To date, the specific mechanisms that drive RA disease remain unknown and provide the impetus for genetic investigations into the development of RA. Researchers hope to identify gene polymorphisms that could serve as treatment targets in patients wi...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000010177
更新日期:2018-03-01 00:00:00
abstract::The use of claims database to study lymphomas in real-life conditions is a crucial issue in the future. In this way, it is essential to develop validated algorithms for the identification of lymphomas in these databases. The aim of this study was to assess the validity of diagnosis codes in the French health insurance...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000009418
更新日期:2018-01-01 00:00:00
abstract::Staphylococcus aureus is a leading cause of infective endocarditis in people who inject drugs (PWID). The management of S aureus endocarditis (SAE) in PWID can be problematic. The objective of this retrospective observational study was to assess the epidemiology, clinical characteristics, and mortality of S aureus end...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005617
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Nutrients related to serum vitamin D level were previously shown to be significantly associated with the risk of many chronic diseases. This study aimed to assess potential relationships between serum vitamin D level and otitis media (OM) risk. METHODS:PubMed, EMBASE, and Cochrane Library databases were sea...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000004739
更新日期:2016-10-01 00:00:00
abstract::Qualitative and quantitative analyses of circulating cell-free DNA (cfDNA) are potential methods for the detection of hepatocellular carcinoma (HCC). Many studies have evaluated these approaches, but the results have been variable. This meta-analysis is the first to synthesize these published results and evaluate the ...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000000722
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Diabetic gastroparesis (DG) is a common autonomic neuropathy which impacts on nutritional state and quality of life in diabetic patients, and it also adversely affects glycemic control in diabetes. The prevalence of DG is growing with the number of patients with diabetes continues to increase. However, there...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000020461
更新日期:2020-05-22 00:00:00
abstract:INTRODUCTION:Atheroma of the facial artery is an extremely rare disease. CLINICAL FINDINGS/PATIENT CONCERNS:Herein, we report an extremely rare case of an atheroma arising from the facial artery, mimicking a parotid gland tumor. DIAGNOSES:The preoperative diagnosis was a right-sided parotid gland tumor. INTERVENTION...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000005403
更新日期:2016-11-01 00:00:00
abstract::The composition of glycan in immunoglobulin G (IgG) has shown to affect various diseases and can be regulated by drugs and preventive vaccination. A hepatitis B surface antigen (HBsAg)-hepatitis B immunoglobulin (HBIG) immune complex (YIC) therapeutic vaccine for chronic hepatitis B (CHB) patients has undergone clinic...
journal_title:Medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/MD.0000000000016208
更新日期:2019-06-01 00:00:00
abstract:RATIONALE:Facial cosmetic surgery sometimes causes complications involving surrounding tissues. In particular, parotid damage may cause fibrous tissue formation, ductal stenosis, and obstruct salivary flow. Affected patients usually complain of symptoms such as pain and swelling. PATIENT CONCERNS:The authors report 2 ...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000015015
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:To perform a systematic review of the effect of time interval on 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) uptake in normal organs. METHODS:PubMed, EMBASE, Ovid, and Cochrane databases were searched to identity all potential eligible literature. The study characteristics and relevant data were extracted an...
journal_title:Medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MD.0000000000013122
更新日期:2018-11-01 00:00:00
abstract::With the rapid increase in the incidence of mental disorders and mental issues, psychiatry has become one of the fastest growing clinical medical disciplines. Development priorities and research foci in this field have evolved over different periods.All the articles in 10 psychiatric journals with the highest impact f...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000007349
更新日期:2017-06-01 00:00:00
abstract::Pneumonic-type adenocarcinoma (P-ADC) is a subtype of lung adenocarcinoma with high mortality, which often requires lobectomy surgery. Nonsurgically treated P-ADC patients usually have more advanced or complex conditions, which remain poorly understood and pose a major challenge in clinical management. We aimed to des...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000015420
更新日期:2019-05-01 00:00:00
abstract::In a retrospective review of 53 patients, 58 episodes of infection due to Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) were studied. Although the organism is widely distributed in nature, it is of relatively low virulence since colonization is more frequently noted than infection and since most inf...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/00005792-197703000-00001
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:To evaluate the efficacy and safety of 10 mg and 25 mg mifepristone per day compared with 3.75 mg enantone in treating uterine fibroids. METHODS:This is a Multicenter randomized controlled trial. A total of 501 subjects with symptomatic uterine fibroids were enrolled and randomized into the group of 10mg, 2...
journal_title:Medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/MD.0000000000006124
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The Pharmaceutical industry sponsorship, research outcome and quality has been already evaluated for clinical trials in order to analyze if this kind of sponsorship affects the results of clinical trials. In this sense, this study has the aim to investigate whether placebo use allows positive outcomes regard...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000022915
更新日期:2020-10-30 00:00:00
abstract::Despite the wide recognition of the inverse association between socioeconomic position (SEP) and suicidal behaviors, its underlying process and potential mediators are little known. This study investigated the pathway from SEP to suicide attempts with attention to potential mediators.From the Korean Health and Nutriti...
journal_title:Medicine
pub_type: 杂志文章
doi:10.1097/MD.0000000000009331
更新日期:2017-12-01 00:00:00
abstract::Custirsen is the second-generation antisense oligonucleotide (ASO), which can reduce cellular levels of clusterin to increase the cytotoxic effect of chemotherapeutic drugs. Our study assessed the efficacy and safety of custirsen in patients with metastatic castration-resistant prostate cancer (mCRPC).We conducted a c...
journal_title:Medicine
pub_type: 杂志文章,meta分析
doi:10.1097/MD.0000000000014254
更新日期:2019-02-01 00:00:00